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https://www.readbyqxmd.com/read/28938310/administration-of-four-factor-prothrombin-complex-concentrate-for-a-life-threatening-bleed-in-a-jehovah-s-witness-patient
#1
Jennifer L Cole, Nathanael D McLeod
: Life-threatening bleeds are medical emergencies that require time-sensitive decision making. Patients of the Jehovah's Witness faith can present a challenging conundrum when their beliefs conflict with modern treatment options for haemorrhage. Providers may not be aware of the grades of acceptance of the newer products outside of packed red blood cells. Researchers present a case of using four-factor prothrombin complex concentrate in a Jehovah's Witness patient in a life-threatening gastrointestinal haemorrhage along with a brief review of the literature...
September 21, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28935445/-usefulness-of-small-bowel-capsule-endoscopy-in-gastrointestinal-bleeding
#2
Chloé Leandri, Benoit Bordacahar, Sophie Ribiere, Ammar Oudjit, Marie-Anne Guillaumot, Bertrand Brieau, Frédéric Prat, Vered Abitbol, Stanislas Chaussade, Romain Coriat
In France, upper gastrointestinal haemorrhages have an estimated annual incidence of 143 cases per 100,000 inhabitants. Classically, two types of digestive hemorrhage are described: acute and chronic digestive hemorrhages. Upper endoscopy is carried out in case of hematemesis or melena. It requires that the patient has been fasting for at least 6hours for solids and 3hours for liquids. The main etiologies of hemorrhagic hemorrhage of the origin are the vascular abnormalities, inflammatory or drug-induced ulcerations, intestinal tumors, Meckel's diverticulum, and Dieulafoy ulcer...
September 18, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28919600/modified-blatchford-score-for-risk-stratification-in-adult-patient-with-nonvariceal-upper-gastrointestinal-haemorrhage-and-their-short-term-hospital-outcome
#3
M S Islam, M Z Uddin, M S Ali, M N Islam, M H Rahman, I H Robi, M M Haque, M W Rahman, M A Uddin, F Ahamed, M S Malek, M A Kabir, M S Rahman, A U Khan, F A Doel
Upper gastrointestinal hemorrhage (UGIH) is one of the most common and life-threatening gastrointestinal emergency. There are several risk scores for risk stratification in UGIB patients. The Modified Blatchford score, which relies only on clinical and laboratory parameters, is practical in the emergency setting The Modified Blatchford scoring system also known as Glasgow Blatchford Scoring (GBS) have been developed to stratify risk of non variceal upper gastrointestinal hemorrhage or need of medical or surgical intervention, endoscopic therapy...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28886932/human-immunodeficiency-virus-associated-giant-conjunctival-kaposi-s-sarcoma-complete-remission-with-antiretroviral-therapy-and-systemic-chemotherapy
#4
Y W Eduardo-Sánchez, D Fernández-Agrafojo
CASE REPORT: A 35-year-old male patient with a large unilateral haemorrhagic conjunctival tumour lesion and another contralateral haemorrhagic conjunctival flat lesion associated with violaceous cutaneous macules on the extremities and angiomatous lesions in the upper gastrointestinal tract as initial clinical manifestation of HIV-related immunodeficiency. Cutaneous, gastric mucosal and conjunctival biopsy was consistent with Kaposi's sarcoma with complete remission after highly active antiretroviral therapy and systemic chemotherapy...
September 5, 2017: Archivos de la Sociedad Española de Oftalmología
https://www.readbyqxmd.com/read/28876573/hemosuccus-pancreaticus-from-ruptured-splenic-vein-pseudoaneurysm-secondary-to-necrotizing-pancreatitis-a-case-report
#5
M L Medina, C Saroca
Hemosuccus pancreaticus is a rare cause of gastrointestinal bleeding in which haemorrhage occurs from the ampulla of vater via the pancreatic duct, mostly from ruptured pseudoaneurysms. Our patient is a 25-year-old Filipino male who presented with intermittent epigastric pain associated with melena and decreasing haemoglobin despite multiple blood transfusions. EGD showed erythematous gastric and duodenal mucosa with no evidence of active bleeding. Whole abdominal CT scan with IV contrast showed diffusely prominent pancreas with areas of non-enhancement suggestive necrosis...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28852961/late-anastomotic-breakdown-with-bevacizumab-in-colorectal-cancers-a-case-based-review
#6
REVIEW
T O'Hare, R McDermott, R Hannon
BACKGROUND: Bevacizumab is the first angiogenesis inhibitor to be approved for metastatic colorectal cancer. Unfortunately, bevacizumab treatment has been associated with a variety of complications including haemorrhage, poor wound healing and gastrointestinal perforation. Late anastomotic breakdown related to bevacizumab therapy however has rarely been described. CASE REPORT: Here, we present the case of a 56-year-old woman who had a bevacizumab-related anastomotic breakdown 17 months following her primary anastomosis...
August 29, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28799620/long-term-bleeding-risk-prediction-in-real-world-patients-with-atrial-fibrillation-comparison-of-the-has-bled-and-abc-bleeding-risk-scores-the-murcia-atrial-fibrillation-project
#7
María Asunción Esteve-Pastor, José Miguel Rivera-Caravaca, Vanessa Roldan, Vicente Vicente, Mariano Valdés, Francisco Marín, Gregory Y H Lip
Risk scores in patients with atrial fibrillation (AF) based on clinical factors alone generally have only modest predictive value for predicting high risk patients that sustain events. Biomarkers might be an attractive prognostic tool to improve bleeding risk prediction. The new ABC-Bleeding score performed better than HAS-BLED score in a clinical trial cohort but has not been externally validated. It was the aim of this study to compare the predictive performance of the ABC-Bleeding score compared to HAS-BLED score in an independent "real-world" anticoagulated AF patients with long-term follow-up...
August 11, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28796572/endoglin-and-alk1-as-therapeutic-targets-for-hereditary-hemorrhagic-telangiectasia
#8
REVIEW
Lidia Ruiz-Llorente, Eunate Gallardo-Vara, Elisa Rossi, David M Smadja, Luisa M Botella, Carmelo Bernabeu
Hereditary Haemorrhagic Telangiectasia (HHT) is as an autosomal dominant trait characterized by frequent nose bleeds, mucocutaneous telangiectases, arteriovenous malformations (AVMs) of the lung, liver and brain, and gastrointestinal bleedings due to telangiectases. HHT is originated by mutations in genes whose encoded proteins are involved in the transforming growth factor β (TGF-β) family signalling of vascular endothelial cells. In spite of the great advances in the diagnosis as well as in the molecular, cellular and animal models of HHT, the current treatments remain just at the palliative level...
October 2017: Expert Opinion on Therapeutic Targets
https://www.readbyqxmd.com/read/28764591/segmental-colectomy-for-bleeding-diverticular-disease-guided-by-the-peep-test
#9
Vijay Naraynsingh, Shamir O Cawich, Dale Hassranah, Feisal Daniel, Ravi Maharaj, Patrick Harnarayan
Many patients with massive lower gastrointestinal (GI) haemorrhage from diverticulosis are subjected to total colectomy when preoperative localisation is unavailable. We dissected colectomy specimens and noted that there was limited retrograde reflux in most of these cases. Therefore, we sought to assess the value of a positive endoluminal erythrocyte presence (PEEP) test (presence of fresh blood in the caecum) to direct segmental colectomies in 14 patients who required emergency operations for massive lower GI haemorrhage...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/28720692/primary-greater-omental-gist-presenting-with-acute-intra-abdominal-haemorrhage
#10
Shariful Islam, Devin Hosein, Vinoo Bheem, Patrick Harnarayan
Primary omental gastrointestinal stromal tumours (GISTs) are classified as extra-GISTs with a reported incidence of <1% of all GISTs. There are only a few cases in the English literature reporting omental GIST with none reporting acute intra-abdominal haemorrhage as a presenting feature. We report a case of a 67-year-old man who presented with haemorrhage from a primary omental GIST requiring emergency laparotomy.
July 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28712008/acute-lower-gastrointestinal-haemorrhage-outcomes-and-risk-factors-for-intervention-in-949-emergency-cases
#11
Kheng-Seong Ng, Natasha Nassar, Deanne Soares, Patrick Stewart, Marc A Gladman
PURPOSE: Outcomes of acute lower gastrointestinal haemorrhage (ALGIH) are mostly derived from studies performed in the sub-acute/elective rather than the emergency department (ED) setting. The aims of this study were to determine the incidence and outcomes of patients presenting to a tertiary hospital ED with ALGIH and to identify associated clinicopathological risk factors. METHOD: A retrospective observational cohort study of consecutive patients presenting with ALGIH to a tertiary hospital ED was performed...
July 15, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28700711/non-vitamin-k-oral-anticoagulants-are-non-inferior-for-stroke-prevention-but-cause-fewer-major-bleedings-than-well-managed-warfarin-a-retrospective-register-study
#12
Vilhelm Sjögren, Björn Byström, Henrik Renlund, Peter J Svensson, Jonas Oldgren, Bo Norrving, Anders Själander
BACKGROUND: For patients with atrial fibrillation, non-vitamin K oral anticoagulants, or NOACs (dabigatran, rivaroxaban, edoxaban, and apixaban) have been proven non-inferior or superior to warfarin in preventing stroke and systemic embolism, and in risk of haemorrhage. In the pivotal NOAC studies, quality of warfarin treatment was poor with mean time in therapeutic range (TTR) 55-65%, compared with ≥70% in Swedish clinical practice. METHODS: We compared NOACs (as a group) to warfarin in non-valvular atrial fibrillation, studying all 12,694 patients starting NOAC treatment within the Swedish clinical register and dosing system Auricula, from July 1, 2011 to December 31, 2014, and matching them to 36,317 patients starting warfarin using propensity scoring...
2017: PloS One
https://www.readbyqxmd.com/read/28665206/primary-aorto-enteric-fistula-as-a-rare-cause-of-massive-gastrointestinal-haemorrhage
#13
Christian-Alexander Behrendt, Sabine Wipper, Sebastian E Debus, Yskert von Kodolitsch, Klaus Püschel, Michael Kammal, Anna Kammal
The incidence of primary aorto-enteric fistula (PAEF) is low with only few case reports and case series published. Depending on the location of the PAEF, the perforation leads to upper or lower gastrointestinal haemorrhages. We conducted a MEDLINE search according to the PRISMA statement. Articles with publication dates from 2000 to 2016 were included and present an own case report. We considered all case reports and series reporting on PAEF and identified 85 individual patients from 32 case reports and five case series...
June 30, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28651669/gastrointestinal-haemorrhage-due-to-lymphangiectasia-caused-by-protein-losing-enteropathy-in-the-fontan-circulation
#14
Pauline Gras, Frédéric Gottrand, François Godart
We report the case of a 14-year-old boy with severe protein-losing enteropathy after Fontan surgery that led to lymphangiectasia, which caused gastrointestinal haemorrhage and required invasive treatment to stop the bleeding. Through this case and a review of the literature on protein-losing enteropathy after Fontan surgery, we highlight a rare and serious presentation of the disease and the difficulties of diagnosis and management.
June 27, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28647788/the-efficacy-and-safety-of-two-low-dose-peri-operative-dexamethasone-on-pain-and-recovery-following-total-hip-arthroplasty-a-randomized-controlled-trial
#15
Yi-Ting Lei, Bin Xu, Xiao-Wei Xie, Jin-Wei Xie, Qiang Huang, Fu-Xing Pei
PURPOSE: To evalute the efficacy and safety of two low-dose peri-operative dexamethasone on pain and recovery following total hip arthroplasty (THA). METHODS: One hundred ten patients received two-dose of 10 mg IV-dexamethasone (group dexa) or IV-isotonic saline (group placebo). The level of C-reactive protein (CRP) and interleukin-6 (IL-6), pain at rest and during mobilization, incidence of post-operative nausea and vomiting (PONV), intensity of nausea, post-operative fatigue, consumption of analgesic and antiemetic rescue, range of motion (ROM), post-operative length of stay (post-operative LOS), wound problems and complications were recorded and compared...
June 25, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28640322/effectiveness-and-safety-of-rivaroxaban-versus-warfarin-for-treatment-and-prevention-of-recurrence-of-venous-thromboembolism
#16
Craig I Coleman, Craig Coleman, Thomas J Bunz, Alexander G G Turpie
The efficacy and safety or rivaroxaban versus enoxaparin/vitamin K antagonist for treatment and prevention recurrence of venous thromboembolism (VTE) was demonstrated in the randomised EINSTEIN trials. We assessed the effectiveness and safety of rivaroxaban versus warfarin in VTE patients managed in routine practice. Using US MarketScan claims from 1/2012-6/2015, we included adults with a primary diagnosis of deep vein thrombosis (DVT) or pulmonary embolism (PE) during a hospitalisation/emergency department visit, newly-initiated on rivaroxaban or warfarin within 30-days after the VTE and with ≥180-days of continuous medical/prescription benefits prior to the VTE (baseline)...
June 22, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28622955/age-specific-risks-severity-time-course-and-outcome-of-bleeding-on-long-term-antiplatelet-treatment-after-vascular-events-a-population-based-cohort-study
#17
Linxin Li, Olivia C Geraghty, Ziyah Mehta, Peter M Rothwell
BACKGROUND: Lifelong antiplatelet treatment is recommended after ischaemic vascular events, on the basis of trials done mainly in patients younger than 75 years. Upper gastrointestinal bleeding is a serious complication, but had low case fatality in trials of aspirin and is not generally thought to cause long-term disability. Consequently, although co-prescription of proton-pump inhibitors (PPIs) reduces upper gastrointestinal bleeds by 70-90%, uptake is low and guidelines are conflicting...
July 29, 2017: Lancet
https://www.readbyqxmd.com/read/28619975/antibiotic-associated-haemorrhagic-colitis-not-always-clostridium-difficile
#18
Olalekan Akanbi, Nasir Saleem, Mohanad Soliman, Bibek Singh Pannu
Antibiotic-associated colitis is a gastrointestinal complication of antibiotic use commonly seen in hospitalised patients, with Clostridium difficile (C. difficile) colitis being the most common type. We present a case of haemorrhagic colitis secondary to Klebsiella oxytoca following self-initiated amoxicillin-clavulanic acid use. An 85-year-old woman presented to the emergency department with abdominal pain and mucobloody diarrhoea. History was notable for an ongoing 5-day course of amoxicillin-clavulanic acid use...
June 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28606079/costs-of-major-intracranial-gastrointestinal-and-other-bleeding-events-in-patients-with-atrial-fibrillation-a-nationwide-cohort-study
#19
Marie Jakobsen, Christophe Kolodziejczyk, Eskild Klausen Fredslund, Peter Bo Poulsen, Lars Dybro, Søren Paaske Johnsen
BACKGROUND: Use of oral anticoagulation therapy in patients with atrial fibrillation (AF) involves a trade-off between a reduced risk of ischemic stroke and an increased risk of bleeding events. Different anticoagulation therapies have different safety profiles and data on the societal costs of both ischemic stroke and bleeding events are necessary for assessing the cost-effectiveness and budgetary impact of different treatment options. To our knowledge, no previous studies have estimated the societal costs of bleeding events in patients with AF...
June 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28588761/apixaban-concomitant-medicines-and-spontaneous-reports-of-haemorrhagic-events
#20
Gillian E Caughey, Lisa M Kalisch Ellett, John D Barratt, Sepehr Shakib
INTRODUCTION: Little is known about the potential safety issues associated with apixaban in clinical practice and their reporting in spontaneous adverse event (SAE) databases. OBJECTIVE: To describe SAE reports associated with the oral anticoagulant apixaban from Australia, Canada and USA and to examine associated concomitant medicine use. METHODS: SAE report databases from Australia, Canada and the USA were examined for all reports of adverse events associated with apixaban and concomitant medicines from 1 January 2012 to 30 September 2014...
May 2017: Therapeutic Advances in Drug Safety
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